About LGBTQ Health

LGBTQ people have many of the same health concerns as anyone else, but cultural differences and the impact of homophobia, biphobia and transphobia and systemic discrimination mean that these health needs may be experienced quite differently.

Due in part to negative past experiences, many LGBTQ people may delay or avoid seeking health care or choose to withhold personal information from health care providers.
In general, LGBTQ people end up receiving less quality health care than the population as a whole.

More Information

More: A 2008 Statistics Canada study showed that gay men, lesbians and bisexuals were more likely than heterosexuals to report having had an unmet health care need in the past year (Health Reports, Vol.19, No.1, March 2008).

Unique Health Concerns

LGBTQ people also have some unique health concerns and may be at increased risk for certain health issues. Most health care providers are not trained on these LGBTQ health needs and may not be sensitive to the particular health risks or knowledgeable about how to work with LGBTQ people. Examples of some of those health needs are:

Mental Health

The mental health of LGBTQ people is impacted by accumulated stigma, prejudice and discrimination, leading to higher rates of depression, anxiety and suicide the general population.

More / research

More / evidence: Findings from a Canadian study provide biological evidence for this by suggesting that exposure to minority stress increases internalized stigma as well as cortisol production in LGBTQ people, both of which are associated with increased depression, anxiety and suicidal thoughts (Benibgui 2011). Stress related symptoms and behaviours are underlying factors in many health problems including substance use, risky sexual activity, and low levels of self-care (GLMA, 2000).

For certain groups, the threat of violence and the impact of familial or community disapproval is particularly intense. LGB youth have been shown in a Canadian study to demonstrate a risk for suicide that is 14 times higher than for their straight peers (Benigbui 2011). A large, statistically representative study of trans people in Ontario found that over 60% had symptoms of depression, 77% had seriously considered suicide, and 45% had attempted suicide (Bauer 2010). Trans youth aged 16 – 24 were especially vulnerable, with 19% reporting suicide attempts in the past year compared to 7% who were 25 or older. Link to fact sheet.

Substance Abuse

Substance use such as alcohol and drugs is higher among LGBTQ populations.

More / research:

A Canadian report on LGBTQ youth found high levels of substance use compared to mainstream adolescents but also related this to the greater levels of homelessness, trauma and sexual abuse to which many LGBTQ youth were subjected. (Canadian Centre on Substance Abuse, 2007). See our Evidence Brief for more information.

Smoking

Smoking rates among LGBTQ people are much higher than the general population.

More / research:

A Toronto study revealed that 36% of LGBTQ adults were smokers compared to just 15% in the general population. Among youth, 50% under 15 and 57% aged 15-19 were current smokers (RTIP 2007).

Depression

Trans people often have unmet health care needs which adversely affect health outcomes, such as higher rates of depression and suicide.

More / research:

The Trans PULSE Study, which surveyed 433 trans people 16 or older in Ontario, found that among trans people, depression was significantly higher among those planning to transition but waiting to begin treatment (Bauer 2012). A further issue related to access was that almost a quarter of trans people who needed hormones reported taking them without medical supervision, and six had performed surgical procedures on themselves (Rotondi 2012).

Even those trans people who had been able to access health care, had significant problems: 21% avoided going to an emergency room even when it was needed, fearing transphobia; over 55% experienced moderate transphobia from their family physician; and 25% of those taking prescribed hormones were not being monitored through regular blood tests. (Zong 2012) Link to THC section of website.

Cancer

LGBTQ communities might be at higher risk for some forms of cancer. Despite this, screening rates are low for our communities. Visit the cancer screening page for more information.

More / research:

While higher levels of lung cancer are a consequence of their increased smoking rates (Makadon 2012), there is evidence that colorectal cancer may also be a significant issue among LGB people (Kanna 2012). Among lesbian and bisexual women, studies show higher rates of breast, cervical and ovarian cancers but it is not always clear if this relates to lifestyle factors (nulliparity, alcohol and tobacco use, higher body mass), to barriers in the health care system (poorer health care, fewer screenings) or a combination of both (Makadon 2012). Among gay and bisexual men there are increased rates of rectal and anal cancer especially in those who are HIV positive. Trans people participate at lower rates in cancer screenings and therefore experience poorer outcomes and delayed diagnoses. Trans men may be at risk of uterine, ovarian, and breast cancer depending on their surgical status, while trans women remain at risk for prostate cancer (Spicer 2010).

Diet, Weight and Body Image

Some disparities in diet, weight and body image have been found between LGBTQ communities and the general population and within LGBTQ communities themselves.

More / research:

Disparities in diet, weight and body-image issues are often differently manifested than in the heterosexual and cisgender (non-trans) populations, with gay and bisexual men showing higher rates of dieting and excessive exercise than straight men (Brennan 2011) and lesbian women showing higher rates of overweight and obesity (Boehmer 2007). Link to fact sheets.

RHO is active in sharing knowledge on these health issues as they affect LGBTQ populations. We also partner with public health units and specific disease organizations to ensure that the issues of LGBTQ people are included in education, health promotion campaigns, print materials and support services. For a full list of our fact sheets please check out our resource section here.